Fibrous stroma and vascularity of pancreatic carcinoma: correlation with enhancement patterns on CT

To demonstrate the contrast-enhancement behavior of pancreatic carcinoma on dynamic contrast-enhanced CT (DCE-CT), and the relationship between the degree of contrast-enhancement and the vascularity (vessel density) and amount of fibrous stroma (fibrosis within the tumor) on pathological specimen. The contrast-enhancement values were measured by producing the subtracting images for obtaining largest region of interests to reduce measurement errors and variability. Vascularity was determined by immunostaining of the tissue sections with factor 8 and the fibrous stroma was determined by picrosirius staining. Correlation of the findings of DCE-CT with pathological findings was performed in 21 patients with pancreatic carcinoma. All but one patient exhibited a gradually increasing enhancement, but there was considerably wide range in contrast-enhancement values of tumors. Examination of the overall relationship between vascularity and fibrous stroma with contrast-enhancement behavior showed that tumor with more fibrosis and higher vascularity had a higher contrast effect through all phases of dynamic study. Tumors having liver metastases tended to be less fibrotic than tumors without liver metastases. The contrast-enhancement behavior of pancreatic carcinoma may be helpful in estimating vascularity and the extent of tumor fibrosis and possibility of liver metastases.